Guselkumab vs Golimumab in PsA TNF Inadequate Responder Patients (EVOLUTION)

Inclusion Criteria:

1. Psoriatic arthritis meeting CASPAR criteria;
2. Active psoriatic arthritis defined by the presence of at least 2 swollen joints OR 1swollen joint and 1 site of active enthesitis OR active dactylitis involving 2 joints
3. At least one active psoriasis plaque;
4. Using a TNFi or previously used a single TNFi historically and either never respondedor lost response (TNF IR) and planning to switch to a new biologic therapy;
5. If using a single oral small molecule/csDMARD (i.e., methotrexate, leflunomide,hydroxycloroquine, sulfasalazine, or apremilast), must be on a stable dose for 4 weeksand remain on a stable dose during the study; Only use of a single OSM/csDMARD isallowed.
6. If using NSAIDs, glucocorticoids (<10 mg daily) or topical medications for psoriasis,must be on a stable dose for 4 weeks and remain on a stable dose during the study;
7. age 18-80

Exclusion Criteria:

1. Prior exposure to golimumab or another non-TNFi biologic (IL12/23i, JAKi, an IL17i, oran IL23i);
2. An adverse event that precludes use of another TNFi (development of drug-induced SLE,allergic reaction, serious infection, heart failure symptoms, demyelination at anypoint during use of therapy) or any other contraindication or substantial intoleranceto a TNFi;
3. Use of moderate to high dose glucocorticoids (>10 mg).
4. Already meet the primary outcome at screening or baseline
5. Currently pregnant or actively trying to conceive